http://link.springer.com/article/10.1007/s00234-017-1840-0
- Cite this article as:
- Moon, H.I., Lee, H.J. & Yoon, S.Y. Neuroradiology (2017). doi:10.1007/s00234-017-1840-0
Abstract
Purpose
Impaired
gait function after stroke contributes strongly to overall patient
disability. However, the response to rehabilitation varies between
individuals. The aims of this study were to identify predictors of gait
velocity change and to elucidate lesion location associated with change
of balance and gait function.
Methods
We
reviewed 102 stroke patients. The patients were divided into two groups
according to gait ability post-rehabilitation, and we analyzed
differences in their characteristics, such as demographic information,
lesion factors, and initial balance function. Multivariate regression
analyses were performed to examine the predictors of rehabilitation
response. Lesion location and volume were measured on brain magnetic
resonance images. We generated statistical maps of the lesions related
to functional gains in gait and balance using voxel-based lesion symptom
mapping (VLSM).
Results
The
group of patients who regained independent ambulation function showed a
smaller lesion size, a shorter duration from stroke onset, and higher
initial balance function. In the regression model, gait velocity changes
were predicted with the initial Berg balance scale (BBS) and duration
post-onset. Absolute BBS changes were also correlated with the duration
post-onset and initial BBS, and relative BBS changes were predicted by
the baseline BBS. Using VLSM, lesion locations associated with gait
velocity changes and balance adjusting for other factors were the
insula, internal capsule, and adjacent white matter.
Conclusion
Initial
balance function as well as the interval between stroke onset and the
initiation of therapy might influence balance recovery and gait velocity
changes. Damage to the insula and internal capsule also affected gait
velocity change after rehabilitation.
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